Successful organ-preserving delivery of a pregnant woman with placenta previa and placenta increta at 41 weeks of gestation
- Authors: Umanskiy M.N.1, Chernobabova T.V.1, Evseev A.V.1, Baranov A.P.1, Berezhnaya E.V.2
-
Affiliations:
- Rostov Regional Perinatal Center
- Rostov State Medical University, Ministry of Health of Russia
- Issue: No 11 (2023)
- Pages: 200-204
- Section: Clinical Notes
- URL: https://journals.rcsi.science/0300-9092/article/view/275123
- DOI: https://doi.org/10.18565/aig.2023.86
- ID: 275123
Cite item
Open Access
Access granted
Subscription Access
Abstract
Relevance: Placenta increta is a severe abnormality of placentation which can cause massive obstetric bleeding and life-threatening complications for a pregnant woman and fetus, and which is classified worldwide as a “near miss”. The issues of tactics of management and delivery in pregnant women with placenta increta continue to be an urgent problem of obstetrics, therefore, it is necessary to continue improving the existing approaches to the delivery in this category of patients.
Case report: This clinical case demonstrates the successful medical treatment of a pregnant woman with placenta previa and placenta increta at 41 weeks 3 days. After a comprehensive preparation, an organ-preserving operation was performed with the involvement of related specialists and the use of modern blood-saving technologies.
Conclusion: It was possible to save the life of a “near miss” patient and perform an organ-preserving operation by using a multidisciplinary approach in a level III hospital. It is necessary to develop and approve a protocol for providing medical care to pregnant women with placenta increta.
Full Text
##article.viewOnOriginalSite##About the authors
Maxim N. Umanskiy
Rostov Regional Perinatal Center
Email: perinatal-rost@mail.ru
PhD, Chief Physician
Russian Federation, 344068, Rostov-on-Don, Bodraya str., 90Tatyana V. Chernobabova
Rostov Regional Perinatal Center
Email: perinatal-rost@mail.ru
Head of the Department of Gynecology
Russian Federation, 344068, Rostov-on-Don, Bodraya str., 90Andrey V. Evseev
Rostov Regional Perinatal Center
Email: perinatal-rost@mail.ru
PhD, Head of the Operating block
Russian Federation, 344068, Rostov-on-Don, Bodraya str., 90Anton P. Baranov
Rostov Regional Perinatal Center
Email: perinatal-rost@mail.ru
obstetrician-gynecologist at the Maternity Department
Russian Federation, 344068, Rostov-on-Don, Bodraya str., 90Elizaveta V. Berezhnaya
Rostov State Medical University, Ministry of Health of Russia
Author for correspondence.
Email: liberezhnaya@yandex.ru
ORCID iD: 0000-0002-2242-8185
6th year student of the Faculty of General Medicine
Russian Federation, 344022, Rostov-on-Don, Nakhichevan lane, 29.References
- Say L., Chou D., Gemmill A., Tunçalp O., Moller A., Daniels J. et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob. Health. 2014; 2(6): e323-33. https://dx.doi.org/10.1016/S2214-109X(14)70227-X.
- Nieto-Calvache A.J., Palacios-Jaraquemada J.M., Osanan G., Cortes-Charry R., Aryananda R.A., Bangal V.B. et al. Lack of experience is a main cause of maternal death in placenta accreta spectrum patients. Acta Obstet. Gynecol. Scand. 2021; 100(8): 1445-53. https://dx.doi.org/10.1111/aogs.14163.
- Башмакова Н.В., Давыденко Н.Б., Мальгина Г.Б. Мониторинг акушерских «near miss» в стратегии развития службы родовспоможения. Российский вестник акушера-гинеколога. 2019; 19(3): 5-10. [Bashmakova N.V., Davydenko N.B., Malgina G.B. Maternal near-miss monitoring as part of a strategy for the improvement of obstetric care. Russian Bulletin of obstetrician-gynecologist. 2019; 19(3): 5-10. (in Russian)]. https://dx.doi.org/10.17116/rosakush2019190315.
- Ищенко А.И., Ящук А.Г., Мурашко А.В., Чушков Ю.В., Мусин И.И., Берг Э.А., Бирюков А.А. Органосохраняющие операции на матке при врастании плаценты: клинический опыт. Креативная хирургия и онкология. 2020; 10(1): 22-7. [Ishchenko A.I., Yashchuk A.G., Murashko A.V., Chushkov Yu.V., Musin I.I., Berg E.A., Biryukov A.A. Organ-preserving operations on uterus with placenta accreta: Clinical experience. Creative surgery and oncology. 2020; 10(1): 22-7. (in Russian)]. https://dx.doi.org/10.24060/ 2076-3093-2020-10-1-22-27.
- Федорова Т.А., Рогачевский О.В., Стрельникова Е.В., Королев А.Ю., Виницкий А.А. Массивные акушерские кровотечения при предлежании и врастании плаценты: взгляд трансфузиолога. Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь». 2018; 7(3): 253-9. [Fyodorova T.A., Rogachevsky O.V., Strelnikova A.V., Korolyov A.Y., Vinitsky A.A. Massive hemorrhages in pregnant women with placenta previa and accreta: a transfusiologist’s view. Russian Sklifosovsky Journal "Emergency Medical Care". 2018; 7(3): 253-9. (in Russian)]. https://dx.doi.org/10.23934/2223-9022-2018-7-3-253-259.
- Jauniaux E., Collins S., Burton G.J. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am. J. Obstet. Gynecol. 2018; 218(1): 75-87. https://dx.doi.org/10.1016/ j.ajog.2017.05.067.
- DÁntonio F., Lacovelli A., Liberati M., Leombroni M., Murgano D., Cali G. et al. Role of interventional radiology in pregnancy complicated by placenta accrete spectrum disorder: systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2019; 53(6): 743-51. https://dx.doi.org/10.1002/uog.20131.
- Cali G., Forlani F., Lees C., Timor-Tritsch I., Palacios-Jaraquemada J.M., Dall’Astra A. et al. Prenatal ultrasound staging system for placenta accrete spectrum disorders. Ultrasound Obstet. Gynecol. 2019; 53(6): 752-60. https://dx.doi.org/10.1002/uog.20246.
Supplementary files
